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Perks, Jemma, Zaccardi, Francesco, Paterson, Craig 
ORCID: 0000-0003-3125-9712, Houghton, John S, Nickinson, Andrew T, Pepper, Coral J, Rayt, Harjeet, Yates, Thomas and Sayers, Robert
(2022)
Effect of high-pain versus low-pain structured exercise on walking ability in people with intermittent claudication: meta-analysis.
British Journal of Surgery, 109 (8).
pp. 686-694.
doi:10.1093/bjs/znac134
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11137 Perks, Paterson et al (2022) The effect of high pain.pdf - Accepted Version Available under License All Rights Reserved. Download (406kB) | Preview |
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11137 Perks, Paterson et al (2022) The effect of high pain Supplementary data.pdf - Supplemental Material Available under License All Rights Reserved. Download (700kB) | Preview |
Abstract
Background The aim was to determine the comparative benefits of structured high-pain exercise, structured low-pain exercise, and usual-care control, to identify which has the largest effect on walking ability in people with intermittent claudication (IC). Methods A network meta-analysis was undertaken to assess two outcomes: pain-free walking ability (PFWA) and maximal walking ability (MWA). Nine electronic databases were searched. Trials were included if they were: RCTS; involved adults with IC; had at least two of the following arms—structured low-pain exercise, structured high-pain exercise or usual-care control; and a maximal or pain-free treadmill walking outcome. Results Some 14 trials were included; results were pooled using the standardized mean difference (MD). Structured low-pain exercise had a significant large positive effect on MWA (MD 2.23, 95 percent c.i. 1.11 to 3.35) and PFWA (MD 2.26, 1.26 to 3.26) compared with usual-care control. Structured high-pain exercise had a significant large positive effect on MWA (MD 0.95, 0.20 to 1.70) and a moderate positive effect on PFWA (0.77, 0.01 to 1.53) compared with usual-care control. In an analysis of structured low- versus high pain exercise, there was a large positive effect in favour of low-pain exercise on MWA (MD 1.28, −0.07 to 2.62) and PFWA (1.50, 0.24 to 2.75); however, this was significant only for PFWA. Conclusion There is strong evidence in support of use of structured high-pain exercise, and some evidence in support of structured low-pain exercise, to improve walking ability in people with IC compared with usual-care control (unstructured exercise advice).
| Item Type: | Article |
|---|---|
| Article Type: | Article |
| Uncontrolled Keywords: | Exercise; Intermittent claudication; Pain: Walking ability; Network meta-analysis; Breast surgery; Vascular surgery |
| Subjects: | R Medicine > RC Internal medicine > RC1200 Sports Medicine |
| Divisions: | Schools and Research Institutes > School of Education and Science |
| Research Priority Areas: | Health, Life Sciences, Sport and Wellbeing |
| Depositing User: | Anne Pengelly |
| Date Deposited: | 06 Jun 2022 10:22 |
| Last Modified: | 31 Aug 2023 09:06 |
| URI: | https://eprints.glos.ac.uk/id/eprint/11137 |
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